Saturday, December 13, 2008

Sleep Hygiene

An issue that haunts me is insomnia. It is something many of us face. I have read the literature and it doesn't put me to sleep!

To know if you suffer from it, offers a sleep hygiene test. It gives you some help, the questions do help you consider your behavioural choices, as much as you habits. (i.e., do you go out after along work week, already witha sleep deficit?) If our loved ones suffer from it, there are things we can do as caregivers. And care recipients can help themselves.

Sleep hygiene can be defined as "all behavioural and environmental factors that precede sleep and may interfere with sleep."*

The typical good health practices apply:
  • Eat regularly - smaller portions, lots of fruits, veggies, whole grains, less meat and proteins since we tend not to need so many calories in middle age, source somemind, body, spirit anti-aging foods
  • Get exercise - 30 minutes per day, come hell or high water!
  • Look after your physical and mental health needs -take a break by going away, getting in respite care through friends, family., or the many non-profit respite care agencies
  • Do meditation on a regular basis - listen to that still small voice
  • Get professional help for your biological, physiological, social and psychological needs
But Julie, on Menopause Mayhem, has some suggestions. Setting yourself up for a regular bedtime, just the way we prepare our children, truly helps.
Have a regular routine: a bath, yoga, read quietly, avoid caffeine, nicotine, alcohol, and other stimulants. There are some natural sleepy time teas that might work.

Being aware of the physical environment is important: soft lights, the right temperature. My Dad was never warm and needed blankets and such to feel comfortable. This isn't the same for those with menopause - I have to keep the air cool, but have plenty of blankets to throw off when I get a hot flash.

The same is true if you are caring for a senior. Visiting our one-year-old granddaughter reminded me of these bedtime routines: bath, teeth, jammies, bed time story, lullaby and quiet songs. Our kids always played music. Also, having CDs play: soft music, or books-on-tape (Jesse always listened to Carol Channing reading Winnie the Pooh. Terry liked to listen to Enya!) I know it sounds incongruous, but it worked for us! I have used relaxation tapes for years. Meditation tapes work for me, as they lull me into lala land. I know that is not their purpose, but it helps.

A Stanford U. site recommends a couple of things I have learned:
Don't lie in bed awake. Get up and do something gentle. Eat something, if you are hungry. Forgo naps. Do not exercise at night. It also echoes the 'hot bath before bed suggestion Julie made. It works for me! Keeping curtains closed to block early morning or moon light has helped me.

For those with dementia, these strategies can be applied to them. Predictable, regular, quiet activities. A careful arrangement of the environment. It didn't work for my Dad, since he'd lost his hearing and hearing aids, but I wish I could have done so! He was very agitated after meals, knowing he wouldn't sleep. After the dinner-time routines, seniors in Long-Term Care are often moved from wheelchairs to beds. Things really quiet down. I recall seeing one man come in every day after dinner to watch the night time news with his failing wife. It was a lovely ritual.
*Van der Heijden, Kristiaan B. et al: Sleep hygiene and actigraphically evaluated sleep characteristics in children with ADHD and chronic sleep onset insomnia. J. Sleep Res. (2006) 15, 55-62. Retrieved on 2008-06-22

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